Radiological Mimics of Popliteal Cysts: An Algorithmic Approach Using US and MRI to Identify the Potentially Malignant Lesions: Case Series

Background: Popliteal cysts are common and present as asymptomatic lumps in the medial popliteal fossa. Some have complex internal characteristics such as septa and loose-bodies. However, not all are popliteal cysts and can be aggressive. These lesions need to be differentiated by the absence of the communicating neck with the joint on ultrasound. Presence of Doppler flow of non-communicating cysts requires further evaluation on MRI, prior to performing a biopsy. Using a case series, we propose an algorithmic approach that is simple and will help identify the malignant lesions and institute appropriate management. Case-Presentation: Popliteal Cyst: On ultrasound: characteristic neck communicating with knee joint. Synovial Sarcoma: Gadolinium enhancement, with areas of low-, iso- and hyper-intense signal to fat on T2. Synovial-Osteochondromatosis: Non-mineralized: T1-low/intermediate intensity;T2-high intensity. Mineralized type: low intensity on T1 & T2. Thrombosed Popliteal Aneurysm: Lamellated appearance-high/low signal intensity on T2. Myxoid-Liposarcomas: Inhomogeneous appearance;homogenous with gadolinium. Usually require a biopsy for diagnosis. Conclusion: The cystic lesions in the medial aspect of the popliteal fossa can be misdiagnosed. Our article reiterates the importance of the communicating neck that separates popliteal cysts from other mimics. We have proposed an algorithm to identify these mimics.

Intra-thyroid esophageal duplication cyst:A case report

BACKGROUND Esophageal cysts are relatively rare in clinical practice,with most of the literature comprising case reports.Esophageal cysts protruding into the thyroid gland are easily misdiagnosed as thyroid tumors.No such cases have been reported so far.CASE SUMMARY This article reports the case of a 31-year-old adult male diagnosed with thyroid nodules before admission.The patient underwent left thyroidectomy and isthmusectomy.During the surgery,esophageal cysts were identified in the esophageal muscle and thyroid glands.The pathology results confirmed a nodular goiter combined with esophageal cysts.Postoperatively,the patient developed a neck infection and underwent another operation and broad-spectrum antibiotic treatment for recovery.CONCLUSION We report the first clinical case of an esophageal cyst located within the thyroid gland that was successfully treated surgically.Esophageal cyst located within the thyroid gland cause difficulties in diagnosis.In the present study,the contents of the esophageal cysts were calcified foci,and a small amount of fluid mixture,which were easily misdiagnosed as thyroid nodules and misled the surgical methods.

Retroperitoneal bronchogenic cyst:A case report and review of literature

BACKGROUND Bronchogenic cysts are rare developmental anomalies that belong to the category of congenital enterogenous cysts.They arise from lung buds and are present at birth.The embryonic foregut is their origin.Typically,they are located within the chest cavity,particularly in the cavum mediastinale of the thoracic cavity or lodged in the pulmonary parenchyma,and are considered a type of lung bud malformation.CASE SUMMARY A 49-year-old male patient was admitted to the hospital due to the detection of a retroperitoneal mass during a physical examination.Two weeks before admission,the patient underwent a physical examination and routine laboratory tests,which revealed a space-occupying mass in the retroperitoneal region.The patient did not report any symptoms(such as abdominal pain,flatulence,nausea,vomiting,high fever,or chills).The computed tomography(CT)revealed a retroperitoneal spaceoccupying lesion with minimal enhancement and a CT value of approximately 36 Hounsfield units.The lesion was not delineated from the boundary of the pancreatic body and was closely related to the retroperitoneum locally.CONCLUSION Following a series of tests,an abdominal mass was identified,prompting the implementation of a laparoscopic retroperitoneal mass excision procedure.During the investigation,an 8 cm×7 cm cystic round-shaped mass with a distinct demarcation was identified in the upper posterior region of the pancreas.Subsequently,full resection of the mass was performed.Postoperative pathological examination reveled a cystic mass characterized by a smooth inner wall.The cystic mass was found to contain a white,viscous liquid within its capsule.

Efficacy of Ultrasound-Guided Unidirectional Valve Enlargement in Treatment of Popliteal Cysts

Purpose: To investigate the effect of ultrasound-guided unidirectional valve cleft enlargement in the treatment of popliteal cysts. Methods: Forty-eight patients with popliteal cysts who met the inclusion criteria and were admitted to our hospital from December 2018 to June 2020 were randomly divided into group A (24 cases) and group B (24 cases). Group A was treated with a central venous catheter dilator, and group B was treated with traditional open surgery to remove the popliteal cyst. Visual analogue scale (VAS) was used to evaluate discomfort. The VAS, Lysholm score of knee joint and Rauschning-Lindgren grade 0~I improvement rate were compared at 6 months after operation. Results: The postoperative VAS in group A was significantly better than that in group B (P < 0.05), and the postoperative Lysholm score and Rauschning-Lindgren grade 0~I in group A were higher than those in group B (P < 0.05). There was no recurrence or other complications in either group. Conclusions: Ultrasound-guided central venous catheter dilator is more effective than traditional surgical resection of popliteal cysts.

Treatment of Popliteal Cyst through Radiofrequency Thermocoagulation under Ultrasound Guidance

Objective: The purpose of this study was to explore the clinical efficacy and security of the treatment of popliteal cyst through radiofrequency thermocoagulation (RFT) under ultrasound guidance. Methods: The clinical data of 35 patients with popliteal cyst, who were treated by RFT under ultrasound guidance from June 2019 to June 2020, were retrospectively analyzed. The Visual Analogue Scores (VAS) and the size of cyst before and after treatment were recorded at the first month, the third month, the sixth month. After six months, the recovery rate of Rauschning and Lindgren classification (R-L classification) level 0, 0 - I were counted. All the complications of the patients were observed. Results: 32 patients were followed up for six months. The scores and cyst sizes of each patient before and after the treatment were on a normal distribution curve. There was no significant difference in VAS scores before and after the treatment (P > 0.05). However, there was a significant difference in cyst sizes before and after the treatment (P < 0.05). Moreover, there was no significant difference in VAS scores and cyst sizes in each period after treatment (P > 0.05). According to the R-L classification in 6 months after treatment: the recovery rate of class 0 was 62.5% and class 0 - I level was 87.5%. There were no serious complications in the process. Conclusion: Treatment of popliteal cyst through RFT under ultrasound guidance is a simple, easy, reliable method that is worthy of clinical promotion.

Pterygium Popliteal Syndrome Concerning a Case in the Pediatric Surgery Department of the Donka National Hospital (Conakry CHU)

Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1st Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.

Robotic-assisted surgery for pediatric choledochal cyst: Case report and literature review

Our paper describes the key surgical points of pediatric choledochocystectomy performed completely by Da Vinci robotic system. A choledochocystectomy was safely carried out for a girl at our hospital, and without any complication. Then systematic literature review was done to discuss the methods of intestine surgery and intestinal anastomosis, the use of 3 rd robotic arm, the surgical safety and advantages comparing open and laparoscopic surgery. We systematically reviewed choledochocystectomy for children performed by robotic surgery. We included a total of eight domestic and foreign reports and included a total of 86 patients, whose average age was 6.3(0.3-15.9) years; the maleto-female ratio was 1:3.5(19:67). Seven patients experienced conversion to open surgery, and the surgery success rate was 91.9%(79/86). The average total operation time was 426(180-520) min, the operation time on the machine was 302(120-418) min, 11 cases used the number 3 arm, and the remaining mainly used the hitch-stitch technique to suspend the stomach wall and liver. Forty-seven patients underwent pull-through intestine and intestinal anastomosis, and 39 patients underwent complete robotic intestine surgery and intestinal anastomosis. The hospitalization time of roboticassisted choledochocystectomy was 8.8 d. Eight patientshad biliary fistula and were all cured by conservative treatment and continuous observation. One patient had anastomotic stenosis, and one patient had wound dehiscence, both cured by surgery. Choledochocystectomy for children performed by completely robotic surgery and Roux-en-Y hepaticojejunostomy is safe and feasible. The initial experience shows that this surgical approach has a clearer field than the traditional endoscopy, and its operation is more flexible, the surgery is more accurate, and the injury is smaller. With the advancement of technology and the accumulation of surgeons' experience, robotic surgery may become a new trend in this surgical procedure.

Adult case of an omphalomesenteric cyst resected by laparoscopic-assisted surgery

This report describes an extremely rare adult case of an omphalomesenteric cyst resected by laparoscopicassisted surgery. A 29-years-old Japanese man was referred and admitted to Kyushu University Hospital because of an abdominal mass and an elevated serum CEA （carcinoembryonic antigen） level （21.3 ng/mL） in August 2001. Abdominal CT and US demonstrated a cystic mass with septum and calcification. Laparoscopy showed a large mass to be attached to his abdominal wall, measuring 110 mm × 70 mm× 50 mm and filled with mucus. The mass was resected by laparoscopicassisted surgery. The histological findings of its wall showed fibromuscular tissue, adipose tissue, calcification, and an intestinal structure. It was finally diagnosed to be an omphalomesenteric cyst.

Maternal choledochal cysts in pregnancy:A systematic review of case reports and case series

BACKGROUND Choledochal cysts(CC)are cystic dilatations of the biliary tract,usually diagnosed during childhood,with an estimated incidence in the general population of 1:100000.Complications related to CC include rupture,biliary obstruction,and cholangitis.Maternal CC in pregnancy are rarely reported,and there are no guidelines on optimal management.AIM To systematically review maternal CC diagnosed during pregnancy or postpartum with regard to the clinical presentation of CC,the mode of treatment and delivery,and maternal outcomes.METHODS A literature search of cases and case series of maternal CC in pregnancy and postpartum was conducted using MEDLINE/PubMed,Web of Science,Google Scholar,and Embase.There were no restrictions on language or publication year.Databases were lastly accessed on September 1,2022.RESULTS Overall,71 publications met the inclusion criteria,reporting 97 cases.Eighty-eight cases were diagnosed during pregnancy and nine in the puerperium.The most common symptoms were abdominal pain(81.2%)and jaundice(60.4%).Interventions for CC complications were required in 52.5%of the cases,and 34%of pregnancies were induced.Urgent cesarean section(CS)was done in 24.7%.The maternal mortality was 7.2%,while fetal mortality was inconsistently reported.Cholangitis,CC>15 cm,and bilirubin levels>80 mmol/L were associated with a higher likelihood of urgent CS and surgical intervention for CC.Bilirubin levels positively correlated with CC size.There was no correlation between age and cyst dimension,gestational age at cyst discovery,and CC size.CONCLUSION Although rare,maternal CC in pregnancy should be included in the evaluation of jaundice with upper abdominal pain.Symptomatology and clinical course are variable,and treatment may range from an expectative approach to emergent surgical CC treatment and urgent CS.While most cases were managed by conservative measures or drainage procedures,CC>15 cm and progressive cholangitis carry the risk of CC rupture and septic complications,which may increase the rates of unfavorable maternal and fetal outcomes.Therefore,such cases require specific surgical and obstetric interventions.

EVALUATION OF SURGERY IN SIMPLE OVARIAN CYSTS

Objective. To evaluate the surgery in simple ovarian cysts.Methods. From Jan.1994 to Dec.1999, 221 women with simple ovarian cysts were admitted into our hospital. The diameter of cysts was <5 cm in 76 cases, and was>5 cm in 145 cases ultrasonically. One hundred and eighty-four patients underwent laparosocopy, and thirty-seven underwent laparotomy.Results. Histological findings showed no malignancy in this series. Simple cysts, paraovarian cysts and corpus luteum were found histologically in 90.8% of cases with cysts <5 cm, and 60% of those with cysts >1 cm respectively, their difference was significant (x2=37.13, P<0.001). The simple cysts, paraovarian cysts and corpus luteum cysts were found in 81.5% of postmenopausal women and 84.0% of pre-menopausal women.Conclusion. Patients with cysts >1 cm are indicated for surgical procedures, while a period of fol-lowup is acceptable for patients with cysts <7 cm, and surgery is advisable if the cyst is persistent during followup. Postmenopausal women with cysts should have operations.

Popliteal Artery Aneurysms

A popliteal artery aneurysm is defined as a dilation of the popliteal artery greater than 20 mm, or greater than 50% at diameter of the native artery. Popliteal artery aneurysms are rare, but are most common in the lower extremities. These aneurysms have a high risk of ischemic complications and amputations even in unoperated patients. We describe the case of a 54-year-old man, hypertensive, with a large popliteal artery aneurysm. Doppler ultrasound and CT angiography of the lower limbs showed a 100 × 80 mm aneurysm of the popliteal artery. This aneurysm is responsible for venous compression with edema of the tissues under the skin. The patient was treated and a flattening of the aneurysm associated with bypass by the inverted right internal saphenous vein taken from the ipsilateral leg was performed. The patient was discharged on the 6th day of the operation. The patient was seen again at the outpatient clinic for one month and in the 3rd month an arterial Doppler ultrasound of the lower limbs performed had shown patency of the venous graft and disappearance of the intermittent claudication.

Primary seminal vesicle adenocarcinoma with a history of seminal vesicle cyst:A case report and review of literature

BACKGROUND Primary seminal vesicle adenocarcinoma is a rare malignancy that is difficult to diagnose.CASE SUMMARY A 54-year-old man with an 18-year history of a seminal vesicle cyst presented with worsening hematospermia that had persisted for one month.Dynamic contrast-enhanced computed tomography and pelvic magnetic resonance imaging indicated a mass with a cystic-solid component.Robot-assisted seminal vesicle tumor resection was performed,and primary seminal vesicle adenocarcinoma was confirmed pathologically.The patient received pelvic radiotherapy for six weeks,and to date,no evidence of recurrence has been found.CONCLUSION Seminal vesicle cysts should be monitored long-term.Seminal vesicle adenocarcinoma presents with non-specific symptoms and can be diagnosed by immunohistochemistry.

Case of takotsubo cardiomyopathy after surgical treatment of liver hydatid cyst: A case report

BACKGROUND Takotsubo cardiomyopathy,also called apical ballooning syndrome,is a disease that is often triggered by stress factors in postmenopausal women and mimics acute coronary syndrome.The aim of this article is to draw attention to takotsubo cardiomyopathy after surgical treatment of liver hydatid cyst.CASE SUMMARY A 50-year-old diabetic and hypertensive female patient was evaluated preoperatively before general surgery for liver hydatid cyst,and no cardiac problems were found.The patient was discharged on the 3rd postoperative day without any postoperative complications.On postoperative day 5,the patient presented to the emergency department with fever,shortness of breath,chills,and shivering and was hospitalized with the diagnosis of pneumonia.The troponin levels remained high during follow-up.Echocardiography was performed on postoperative day 7,after which the patient was referred to a tertiary center with the diagnosis of non-ST-elevation myocardial infarction due to akinesia in the apical region.Coronary angiography performed at the tertiary center showed normal coronary anatomy,and the patient was diagnosed with takotsubo cardiomyopathy.CONCLUSION Takotsubo cardiomyopathy mimicking myocardial infarction without ST segment elevation may develop after surgical treatment of liver hydatid cyst.

Two Cases of Epidermoid Cyst of the Buccal Floor Simulating: A Tumour of the Submandibular Gland

Dermoid cyst of the oral floor is rare benign tumour, who having three histological aspects: dermoid, teratoid and epidermoid. This one is characterized by the presence of a squamous stratified epithelium with cutaneous remnants. It may occur in any part of the body, however their frequency in the ENT sphere is relatively scarce. Seven per cent (7%) only of epidermoid cysts occur in the cervico-facial area, 1.6% of which locate at the floor level. When they are located submandibular, they can pose diagnostic difficulties and look like a tumour of the submaxillary gland. We report two cases of epidermoid cyst of the floor. Both patients suffered from swelling of the submandibular gland. Magnetic Resonance Imaging was not requested due to lack of resources. However, surgery allowed in both cases the excision of a cyst next to a normal submandibular gland. Patients did well post operatively.

First Cases of Amygdaloid Cyst in Adults in Djibouti: Case Report of Two Patients

Amygdaloid cysts are rare cystic benign tumors due to congenital malformations resulting from an anomaly of embryonic development of the upper laterocervical region, originating from the second branchial cleft. They represent approximately 2% of all laterocervical tumors and 6% to 85% of anomalies of the second branchial cleft. This anomaly of the second branchial cleft is a frequent reason for consultation in the pediatric population but is relatively rare in adults. We report the cases of two patients aged 23 and 34 years with no particular pathological history. They were presenting a laterocervical swelling, one right and the other left, painless, evolving for two years for the first and for 10 years for the second, gradually increasing in volume without any other associated signs the diagnosis of which after radiological exploration (ultrasound and CT scan) was that of an amygdaloid cyst. A cervicotomy with anatomopathological examination of the surgical specimen confirmed the diagnosis of the amygdaloid cyst. The objective is to analyze the anatomo-clinical and therapeutic particularities of this pathology and to compare it with data from the literature.

经尿道输尿管软镜钬激光肾盂旁囊肿内切开引流术对患者的治疗效果

目的 分析经尿道输尿管软镜钬激光肾盂旁囊肿内切开引流术对肾盂旁囊肿患者手术相关指标与并发症的影响。方法 选取2021年1月至2023年4月郑州市第二人民医院收治的50例肾盂旁囊肿患者,按掷硬币法分为两组,各25例。对照组接受腹腔镜下肾盂旁囊肿去顶减压术,观察组接受经尿道输尿管软镜钬激光肾盂旁囊肿内切开引流术,对比两组手术效果。结果 两组手术效果(96.00%、80.00%)和并发症发生率(8.00%、20.00%)差异无统计学意义(P>0.05)。观察组手术时间、术后卧床时间、住院时间短于对照组,术中出血量少于对照组(P<0.05)。治疗后两组C-反应蛋白、白细胞介素-6、白细胞介素-1β水平、肿瘤坏死因子-α以及降钙素原水平下降(P<0.05)。结论 经尿道输尿管软镜钬激光肾盂旁囊肿内切开引流术可减少手术创伤和出血量,基本不产生应激反应,可降低炎症因子水平,对术后恢复更有利。

胆总管囊肿切除术后胆肠吻合口狭窄的腹腔镜手术处理

目的 总结胆总管囊肿切除术后胆肠吻合口狭窄再行腹腔镜手术处理的疗效。方法 回顾性分析2019年7月至2024年4月武汉大学人民医院收治的胆总管囊肿切除术后胆肠吻合口狭窄,再行腹腔镜下胆肠吻合口重建的患者资料。再次腹腔镜手术过程分为三个部分:解剖复位各相关器官,建立大口径的胆管开口、取石,重建胆肠吻合、肠肠吻合。分析胆肠吻合口重建手术的手术时间、术中出血量、肛门排气时间,以及术后住院时间、术后并发症情况。结果 根据纳排标准,本研究筛选出13例胆总管囊肿切除术后胆肠吻合口狭窄再行腹腔镜手术的患者资料。第1例患者中转开腹完成手术,其余12例均通过腹腔镜完成手术。手术时间3.5~5.0 h,平均(4.1±0.6)h;术中出血量20~150 mL,平均(61.5±41.4)mL;术后肛门排气时间2~4 d,平均(2.5±0.7)d;术后住院时间7~12 d,平均(8.8±1.9)d;术后发生胆瘘2例,无术后腹腔感染、腹腔出血、再手术、术后死亡患者。所有患者随访9~57个月,平均(32.3±15.1)个月,随访期间未见胆肠吻合口再狭窄患者,1例患者出现胆管炎表现,经保守治疗缓解。结论 胆总管囊肿切除术后胆肠吻合口狭窄再行腹腔镜手术重建胆肠吻合口,安全有效。

经后路显微手术切除胸椎神经根束膜囊肿1例

神经根束膜囊肿发病率不高,多数学者认为其形成原因与先天发育异常、创伤等因素有关,其形成机制以“球阀机制”学说较为合理。多数神经根束膜囊肿无临床症状,无需特殊处理;少数伴有临床症状者,建议手术治疗,但手术方式仍存在争议。本文报道1例59岁女性,因检查发现胸腰椎多发囊肿2年、左侧卧位时右侧腹部疼痛不适1年余入院,视觉模拟量表(VAS)评分4分,胸腰椎增强MRI检查示胸10/11双侧、胸12/腰1右侧椎间孔区多发无确切强化囊性病灶。病人存在大小不等、位置不同的4个囊肿,仅右侧胸10/11椎间孔区处的较大囊肿在左侧卧位时才出现神经根压迫症状,其余三个囊肿均未引起临床症状。完善术前准备后,在全麻下行右侧胸10/11囊肿囊壁部分切除+神经根袖套成形+自体脂肪-肌肉-蛋白胶囊肿填塞术治疗,术后6 h右侧腹部疼痛消失,术后3个月电话随访,无右侧腹痛,未再行影像学复查。这提示对于有症状的胸腰椎神经根束膜囊肿,行神经根束膜囊壁部分切除+自体脂肪-肌肉-纤维蛋白胶囊肿填塞术治疗可取得满意效果。

肾盂旁囊肿的临床诊治

目的探讨肾盂旁囊肿的诊断与治疗方法。方法回顾性分析2019年1月至2023年1月上海市徐汇区中心医院泌尿外科收治的65例肾盂旁囊肿患者的临床资料,比较B超、静脉尿路造影(intravenous urography,IVU)和CT尿路成像(computed tomography urography,CTU)对肾盂旁囊肿的诊断价值,并进一步比较不同手术方式治疗肾盂旁囊肿的效果。结果65例患者均行B超检查,提示肾门处囊性占位;55例患者行IVU检查,均未发现囊肿显影,其中7例由于患侧肾盂显影不佳行膀胱镜肾盂逆行造影术;53例患者行CTU检查,均明确显示肾盂以及囊肿。65例患者中5例未行手术治疗,随访观察;60例接受手术治疗,4例术前考虑恶性可能行根治性肾切除术,56例行肾囊肿去顶减压术,其中11例为开腹手术,37例为腹腔镜手术,8例为达芬奇机器人辅助腹腔镜手术。开腹手术组患者的手术时间显著短于腹腔镜手术组和达芬奇机器人辅助腹腔镜手术组;与开腹手术组和腹腔镜手术组相比,达芬奇机器人辅助腹腔镜手术组的术中出血量更少,术后镇痛药使用率更低,患者术后首次下床活动时间、术后住院时间均更短。结论B超、IVU及CTU是诊断肾盂旁囊肿常用的有效检查。B超可作为常规检查,而CTU较IVU在肾盂旁囊肿诊断上准确率更高。与开腹手术相比,腹腔镜及达芬奇机器人辅助腹腔镜肾盂旁囊肿去顶减压术的术中出血量更少,术后恢复更快。

超声引导下腘窝坐骨神经联合收肌管阻滞用于膝关节置换手术镇痛的效果评价

目的评价超声引导下腘窝坐骨神经联合收肌管阻滞用于膝关节置换手术镇痛的临床效果。方法选取2020年1月至2023年7月在湖州市南浔区人民医院择期行单侧膝关节置换手术的60例患者纳入研究,按随机数表法分为A组和B组,每组30例。A组患者全麻前超声引导下行腘窝坐骨神经阻滞,B组患者全麻前超声引导下行腘窝坐骨神经联合收肌管阻滞;两组患者均行术后静脉镇痛。比较两组患者的感觉阻滞起效时间及维持时间、运动阻滞起效时间及维持时间、麻醉诱导前、手术切皮时和手术结束时的血流动力学;同时比较两组患者术后4 h、8 h、24 h和36 h的视觉模拟评分(VAS),以及术后36 h内的镇痛泵首次按压时间和镇痛泵有效按压次数。结果B组患者的感觉阻滞起效时间为(11.88±0.27)min,明显短于A组的(14.1±10.22)min,感觉阻滞维持时间为(747.00±23.08)min,明显长于A组的(571.90±17.98)min,差异均有统计学意义(P<0.05);但两组的运动阻滞起效时间和运动阻滞维持时间比较差异均无统计学意义(P>0.05);B组患者在手术切皮时、手术结束时的心率分别为(69.38±5.2)次/min、(66.79±4.73)次/min,明显低于A组的(72.97±5.2)次/min、(69.40±5.06)次/min,而平均动脉压分别为(92.91±8.08)mm Hg、(94.67±8.69)mm Hg,明显高于A组的(89.29±7.58)mmHg、(86.70±7.28)mmHg,差异均有统计学意义(P<0.05);术后8 h、24 h、36 h,B组患者的VAS评分分别为(4.12±0.06)分、(3.42±0.12)分、(2.44±0.10)分,明显低于A组的(4.87±0.15)分、(4.61±0.09)分、(3.47±0.16)分,差异均有统计学意义(P<0.05);术后36 h内,B组患者的静脉自控镇痛泵首次按压时间为(306.8±0.90)min,明显长于A组的(177.3±1.47)min,差异均有统计学意义(P<0.05);术后24 h、36 h,B组患者镇痛泵有效按压次数分别为(1.35±0.04)次、(2.55±0.09)次,明显少于A组的(1.66±0.05)次、(3.48±0.09)次,差异均有统计学意义(P<0.05)。结论超声引导下腘窝坐骨神经联合收肌管阻滞能提升膝关节置换手术患者的麻醉效率,维持血流动力学稳定,同时确保围手术期镇痛效果,使术后自控镇痛应用频率降低。